Surgery
A drop in blood pressure, muffled heart sounds, and jugular vein distension are the classic signs of this life-threatening complication following cardiac surgery.
What is cardiac tamponade?
This medication for selected post-op heart transplants requires pre-medication, a 0.22 micron filter, and careful monitoring for side effects that may necessitate a rate adjustment rather than discontinuation.
What is Thymoglobulin?
During a code blue in a patient with an Impella device, reducing support by this many P levels can help minimize suction events and allow for the Impella to assist with venting the ventricle during compressions for improved perfusion.
What is 1–2 P levels?
At this stage (full thickness skin loss), the nurse should obtain a wound consult.
Stage 3, 4, or Deep Tissue Injury/Unstageable
This animal was on a CVICU staff t-shirt.
What is a whale?
A salem sump nasogastric tube is a vital device for all immediately post-op lung transplants and, if not placed in the OR, can be placed bedside by this very important member of the care team.
The bedside RN.
Per Dr. Afshar, NGTs are essential for all lung transplants in the immediate post-operative period and DOES NOT need to be placed by a physician or with a scope.
This infusion is a phosphodiesterase-3 inhibitor, providing both increased contractility and afterload reduction, making it useful for heart failure patients with high systemic vascular resistance.
What is milrinone?
A curos cap must remain on for this long before accessing an IV port.
What is one minute?
These are the 3 places to find wound care orders.
1) Yellow sticky note on summary page in EPIC. 2) Active orders hyperlink on summary page. 3) Wound consult note in Notes
Zoom links for charge, shared governance, and education meetings can be found here.
What is CVICU SharePoint, right hand side, bottom of the red boxes (quick links)?
This highly intricate type of surgery performed at UCSD has the surgeons describing it like "separating wet layers of tissue paper".
What is PTE surgery?
This is used in critically ill patients to selectively reduce pulmonary vascular resistance and improve oxygenation without causing systemic hypotension.
What is inhaled nitric oxide (iNO)?
Pacer spikes which appear in unexpected areas of the ECG tracing is a sign of this failure.
What is failure to sense?
The number of days before a foley anchor needs to be changed.
What is 7 days?
This is the optimal time preferred by surgeons to get a neuro assessment after a patient is brought to the ICU from the OR post-op.
What is 4-hours?
This is the maximum amount of time for intra-operative "circulatory arrest" before the patient must be rewarmed before re-cooling can occur.
What is 20 minutes?
This "Hail Mary" medication for vasopeligia can also cause serotonin syndrome and interfere with the ability of the pulse oximeter to read an accurate peripheral oxygen saturation
What is Methylene Blue
Bonus: Side effects include hypokalemia, hypomagnesemia, increased LFTs, green urine, serotonin syndrome (with concurrent use of SSRIs, SNRIs, MOAs, and Fentanyl), and pulmonary vasoconstriction.
To ensure accurate readings, the extra tubing sometimes added by the cath lab should be removed in the CVICU when managing this device.
What is an IABP device?
This order gives the nurse the ability to remove a foley without consulting the provider.
What is the Nurse Driven Foley Removal protocol?
Flu-like symptoms, dyspnea, nausea, vomiting, heart failure, and dysrhythmias are key indicators of this serious antibody-mediated rejection that can occur after a heart transplant.
What is Acute Humoral Rejection?
This is the minimum desired spinal perfusion pressure in patients with a lumbar drain.
SCPP > 60
Bonus: Spinal Cord Perfusion Pressure = MAP – CSFP (Cerbrospinal Fluid Pressure or ICP on the monitor) or CVP, which ever is greater.
Your patient is POD#3 from a CABGx2. This is the first action to help boost your patient's blood pressure if they go into a junctional rhythm.
What is epicardial pacing?